Having a little money is good for your health.

We know intuitively and statistically that living in a safe home with clean water, a full fridge, a decent mattress makes it easier to learn in school and shine at work.

There's something else, something that turns up in every study and report like this plain fact that wants our attention.

A white woman with an eighth grade education has a higher likelihood of surviving childbirth than a Black woman with a master's degree.

Linda Villarosa taught me that.

For 3 decades, she's been studying our system, looking for ways to make things better, more human by writing essential books and teaching a new generation of medical students who want to care for everyone equally.

I'm Kelly Corrigan, this is "Tell Me More," and here is my conversation with conscientious student and teacher, powerhouse journalist, and lifelong optimist Linda Villarosa.

♪ Hi.

Hi.

How are you?

Good.

Good to see you.

Come in.

Thanks for coming in.

Come on up.

We're just gonna go right here in the office.

Corrigan: You come by your work really honestly.

Your father was a biologist, and your mother was a hospital administrator?

And a bookstore owner and a social worker.

Oh, wow.

So tell me about them.

My father was a very courtly person.

Very smart, very patient, really funny, great sense of humor.

My mother is a fireball.

She is super dynamic, no filter, very wise and smart.

They sound like great parents.

Great parents.

So you got a new house in third grade?

Yes.

We were living in Chicago.

I remember we packed up, and we were told--my sister and I were told we were moving to Denver.

You're gonna get your own rooms.

We drove up thinking, you know, how excited we were to get in that new house, and then on the garage door was "N-word, get out."

My father said, "Let's go home.

"We do not need to be here.

"Let's just go back to Chicago.

We don't belong here," and then some of the neighbors came and helped clean it off, and my mom said, "Let's try and stay," but it was really hard, and the kids who did it lived two doors down, and I went to school with them all through school.

I knew them, and I knew they had done it.

You and your sister were the first Black kids in your whole school?

Yes, in elementary school, and then we got twins later in school, and their names were the Soul brothers, so it was me and the Souls.

Uh-huh.

You were the president of your class?

I was the captain of the track team.

I was in Spanish Club, Honor Society, and the president of my class just really trying to achieve my way out of some of the harsh things that were happening growing up in an all-white community.

Like what?

You know, everybody trying to touch your hair, people saying things.

A boy I went out with, his parents said, "You cannot go out with her."

Luckily for me, I turned out to be gay, so that didn't-- See you later.

That wasn't, like, a huge thing, but it was at the time to have the parents say, "No, don't bring her home."

So you started your professional life at "Essence," and there was this assumption there that each one of the staffers was responsible for 8 Black women and their well-being.

What was your piece of the puzzle?

My responsibility was the health of the whole race and then 8 imaginary Black women in my head that I was taking care of, so I was saying to them, "You have to do "everything right.

"You have to eat right.

"You always have to exercise.

"You have to not get pregnant "unless you want to, and if you do, "you have to take care of your baby "and have a healthy pregnancy.

"Then you have to take care of the children "in your life "and all the other people in your community "and the men in your life.

"If everyone does, it will just uplift the health outcomes of the race as a whole."

Coming from a family of aspirational people, that just was the way-- what I was taught, and many of us at "Essence" were that way, and that was kind of a little bit of a mantra is just like, "If you know better, you'll do better."

Yeah, and each one teach one.

Exactly, and to-- you know, to some extent, I believe that, but I don't think it is the way to solve the problem of racial health disparities in America.

I mean, this is definitely like an "and not or" conversation.

I did want to pause here and talk about willpower as an idea that you can start walking and eating kale and all the problems will disappear.

I, you know, eat kale, and I like walking and running and drinking a lot of water, but that isn't the whole answer to the picture because there's so much more going on in our country and in our world.

Much of it is environmental.

Much of it has to do-- for Black people and other people of color and other oppressed people has to do with how you're treated and the effect on your body, so I, of course, think everyone should do the right thing, but it isn't the answer to avoiding personal illness and definitely not the answer to "uplifting," in quotes, the race.

There were two huge reports that changed your thinking, the "Heckler Report" and then "Excess Mortality in Harlem."

Can you talk about those?

Well, the "Heckler Report" was really interesting because it was by the Secretary of Health, Margaret Heckler, who wasn't exactly the most progressive person.

She was a Reagan appointee, but she was the person who pushed to look at the health of Black people in America, and this was the first time it was documented.

Mm-hmm.

"Excess mortality in Harlem" came later in 1990 In the "New England Journal of Medicine."

One of the authors of the report was Harold Freeman, and I met him the following year in 1991, and I remembered the headline "Black men in America live fewer years than men in Bangladesh."

Why is there a place in America where people are living so few years compared to a much, much poorer country?

And Harold Freeman, his work and his thinking is foundational to me.

He came to where you were studying, and you just glued yourself to him, pummeled him with questions.

I glommed onto him and was like, "How can this be happening in America?

Please explain this to me."

My assumption was that this was simply because of poverty, but actually he set me straight by saying, "No, be careful.

Don't conflate race and poverty or poverty and race."

He also pointed out that not everyone in Harlem is poor.

In his study, a quarter of the people were not poor, but still, there was this low life expectancy, and I really listened to him.

This was foundational.

It was important to me.

It was important for me to hear him, to later go and follow him, shadow him in his practice at Harlem Hospital.

He is one of the smartest people that I know and also one of the kindest.

I'm guessing that Dr. Freeman is your Plus One, which is our way at "Tell Me More" of shouting out someone who's been so instrumental to your work and your well- being.

Am I right?

You're right.

Well, here's to Dr. Freeman.

Dr. Freeman.

Conflating race and class sort of obscures this key point that you're trying to teach everyone and correct for, and one of the factors inside it is that Black people are afraid to go to the doctor, and there are really good reasons for that.

Yes.

When we used to talk about Black people being afraid to go to the doctor, it used to be this discussion of the Tuskegee experiment.

Yeah.

And certainly the Tuskegee experiment was terrible.

Beginning in the thirties, Black men in Alabama who had syphilis were not treated, and the Public Health Service, which is the government, watched the course of the disease without treating the men.

It ended in 1972 by journalists, who uncovered it, but most people that are afraid to go to the doctor are not thinking about the Tuskegee experiment.

They're thinking about what happened to them the last time they entered the health care system.

They're thinking about what happened to a loved one what happened to a neighbor, and so there is real fear and real reason for fear because of discrimination in the health care system among doctors and everyone from the person who greets you at the door all the way to the person who does surgery, and it's not a kind of explicit, you know, Proud Boys kind of racism.

It's a kind of racism that just is part of our society.

In 1973, it was revealed that somewhere between 100,000 and 150,000 young poor people, most of whom were Black, had been sterilized.

Is that more or less like slow genocide?

Well, I came to that story through the Relf sisters.

So the Relf sisters were 12 and 14 in 1973 when they were sterilized without their parents' consent.

The Southern Poverty Law Center brought the lawsuit forward, and they won, so now you cannot be sterilized without explicit, informed consent.

The good part about the Relf sisters is they're still alive.

They live in Alabama, where they're from, together, and then their story was a cover story on the "New York Times Magazine," and a woman e-mailed me out of the blue and said, "Oh, I am someone who read your story.

"I'm so moved by the Relf sisters' story "that I'd like to give them money, "and I see that other women who were sterilized received $25,000."

So I thought, is this a scam?

So I ended up calling her, and my first question was "When you say $25,000, do you mean each?"

Ha ha ha!

And she did.

And so earlier this year, the Relf sisters bought a house, so they moved out of public housing, and now they live together, and it's a nice story, but they still never received an apology, an official government apology, and in their state, there's no reparations, as there are in other states, for people who were sterilized without their consent and against their will, and I think the thinking was these are poor people, and these are Black people, and these are marginalized and oppressed people who should not be having children.

When my excerpt of the Relf sisters story ran in the "New York Times Magazine," there were people in this day and age who were saying, "Well, maybe they shouldn't "have had children because they couldn't take care of them, they were poor," but in this country, we have the right to have a child.

You should have the right not to have a child, and you should have the right if you have a child that that child is raised in a healthy, safe environment.

That is the fundamentals of reproductive justice, but we don't have that always in this country.

Is it true that there are more recent examples of sterilization happening in the United States?

Yes.

With immigrants, women, incarcerated women, it's still happening, and I think there is this idea that some people are not-- don't deserve to have children, and that exists still.

There's a lot of fake news around the differences between a Black body and a white body.

Can you talk about an example of something that persists today that maybe people aren't aware of?

One of the most persistent myths and one of the most dangerous is the idea that Black people have superhuman tolerance to pain.

That comes from centuries ago, from when Black people were still enslaved, and that was a myth that was pushed by scientists and even doctors, many of whom owned slaves, and that myth persists, and there are studies even more current that show that medical students and medical residents still believe many of those myths.

It means that Black people don't get enough pain management.

I looked at a study in 2019, and it was about C-sections.

It was from the University of North Carolina.

It found that even when Black women complained more of pain when getting a C-section, received less attention for that pain and less pain management.

I think of the case of Dr. Susan Moore, who was a physician herself, who entered the health care system that she worked in in 2020-- the end of 2021 with COVID.

She was empowered to speak.

She asked for pain medication.

She also talked about the treatment she should receive.

She was shut down.

She ended up leaving that hospital and dying, and then when there was an investigation of that hospital system in Indiana, one of the things that they found was that some of the medical staff was intimidated by her medical knowledge, so that didn't help her to be empowered to speak up for herself and to even have a lot of knowledge.

It may have even hurt her.

So while you were doing all this research and writing, your mom called and said, "You have to come right away.

"Your father's in the hospital, and they have him in restraints."

Why did they restrain him?

They restrained him because he was really upset.

Very, very upset.

He was--we later found out he was dealing with colon cancer.

He was not treated very kindly, and so the more he didn't get the information he needed, he was very upset, so by the time we got there, he was a mess.

He was wearing a dirty gown.

He was restrained.

His hair was in disarray, and the thing about my father was he's courtly, he's quiet, he's really kind.

He's trained as a scientist.

If you would speak to him in a kind way, in a respectful way, he would have understood.

When you got to the hospital, you leaned over, and your father whispered in your ear, My father said, "Get me out of here," and that was a hospital that he chose because he was a veteran, and it meant something to him that he deserved this care, at this place because he served his country, but then he realized that he was being treated badly.

Even in his state, he knew he needed to leave, and that's what my mother and I did.

We got him out of there.

He died not long after, but I just remember if my father could be treated that way with a lack of respect, a lack of understanding, and an assumption that he was angry and dangerous, though he was really ill and needed treatment and care, then that can happen to anyone.

I've heard it said that there's a burden of proof that persists instead of a presumption of value.

Yes, definitely.

The very saying is "First, do no harm," but I think what happens in our system, in the systems of America and in the health care system itself, people bring in their biases, and if you don't confront that, then you get poor treatment.

There's enough evidence.

There have been report after report after report, but if you don't believe the reports, then please just listen to what people are saying.

Look at the case of Dr. Susan Moore.

Black people are entering the health care system and not being treated kindly, and I'm telling you my own story of my own family members.

Please just listen.

This isn't--we don't need any more evidence.

We need action.

There's a term that you bring to life in your book by Arline Geronimus.

What is weathering?

I love that term.

Arline Geronimus is a professor at the University of Michigan.

Weathering is also now the title of her new book.

She's been studying the idea that something about pushing against discrimination, just sort of striving and surviving against discrimination creates a kind of a premature aging in your body, the same way a rock is weathered by the waves in the ocean.

The flip side is we still weather the storm, the storm of being treated poorly through love and kinship and family and community, so I really like the positive part of that, too, and what she says is when you have a--something happens to you, you have this instance of some kind of discrimination or ill treatment, you get angry, and the systems of your body fire up, including your blood pressure, your heart rate, your stress hormones, and when this happens occasionally, that's fine, but when it happens over and over and over again, it's bad for your body, and I'm so happy for her career and that she's being heard now.

You're teaching now, and we had a great conversation a few seasons ago with Atul Gawande, and we talked about if what medicine needs now is the person who can ace organic chemistry as a freshman in college or if what medicine needs now is a different kind of thinker-feeler.

What are you seeing in your classes?

I taught premed last semester at CUNY Medical School, and it was such a wonderful experience.

I had a class, all people of color.

I knew it took them so much to get to medical school, many of them, and what I saw was people committed to going back to their communities and serving, and I was so excited to teach them, and many of them didn't know about the-- you know, I was basically using my book as the textbook.

Many of them didn't know about the history of America and its discrimination, and, you know, it was really moving to see them being surprised and then seeing the light bulb go on and then seeing another light bulb go on to say, "I'm not gonna do that."

That's where a lot of the energy for change is happening-- in medical schools.

Today's medical students, many of them were politicized.

They were in high school or undergraduates in college when the police killings of Black people started happening, and they became political, and that's come with them to medical school.

This idea that Black people have a superhuman tolerance against pain, you know, some of these things are in current textbooks.

I see them pushing back against the administration, against the textbook, against the professor, and I'm impressed that many are trying.

You are an optimistic person, and I wonder, is it by nature, is it your intuition, or is it evidence-based?

All 3.

I'm an optimist, I think, but there's also evidence.

When I look at those medical students trying to do better, to try to be better, I think, "Oh, this is change."

When I look at the work of Dr. Freeman, Dr. Freeman created the patient navigator system at Harlem Hospital to help people with cancer navigate the system, so pairing that person with someone from the community who may have experienced cancer themselves and helping them enter the system for treatment and care, and I think of doulas.

Doulas have been some of my greatest sources of information as a journalist, and those are people that help birthing people navigate the health care system when they're pregnant and going through labor and delivery and the time after.

People like those that are so committed to doing good and taking care of other people, they make me optimistic, they make me hopeful.

Until we can make significant change to the system, then we have to use a kind of limp along plan, which is people helping other people to get through the system, to get the treatment and care that they deserve, but I tried to in my book and in my thinking come up with solutions like doulas and patient navigators and racial bias training.

And there was a huge-- California took a huge step in racial bias training that could be a model.

What California did was change the hospital system.

California had the same numbers of maternal mortality and morbidity as the rest of the country, so the state said, "We're gonna fix this problem "at the hospital level.

"If there's a hemorrhage "or if there's an emergency C-section, "we will have all the tools ready to go and a list of protocols of what to do."

So they put that system in place, and maternal mortality and morbidity dropped 55% in the state...

Right.

but then what didn't change was the racial disparity because it mostly benefited white women and to some extent Latinx women.

So then what--what California did, which was really wonderful, was to say, "If you're someone who works with birthing people, you must go through some kind of anti-bias training."

Climate has a huge impact on health.

Can you talk about the right to clean air?

It was hard for me to understand the social determinants of health.

Some communities are polluted.

There are communities that are food deserts.

There's not enough healthy, affordable food.

There's not enough green space to exercise in.

The air, the water, and the land is polluted.

Black people are 75% more likely to live in these kinds of communities.

That contributes to poor health outcomes.

Because it's totally inescapable.

It's totally inescapable, and I think for my own family-- my parents are both from Chicago, and when my mom and I went to Chicago in 2020 and we realized that the health outcomes were so poor but also that life expectancy-- people in my mother's community, where she grew up, lived to only age 60, and people in the community 9 miles north lived to age 90.

So there's--the largest gap in life expectancy is between my mother's community and actually the community where we were staying in our hotel.

So this whole season, we're trying to understand what does it take to make it in America today.

Do you feel like anyone can make it in America today?

No, and I just got into an argument about this, where someone was talking to me.

It's like "Anyone can make it in America today."

And I think that, no, there are people who are severely disadvantaged, and it's hard to dig out of that, and it's unfair to say that anybody can make it.

There--so many people have advantages that so many others don't have, and I think a lot about that, and I try to, you know, act with empathy, act with sort of vision, act with, you know, using my gut when I'm doing my work and thinking about people, and I do think that I don't like when people say things like, "Oh, anybody can make it in America," without thinking deeply and empathetically about the systems that are against us in this country.

All right, Linda Villarosa.

Are you ready for the "Tell Me More" speed round?

I'm ready.

What's your first concert?

The Jackson 5.

Best live performance you've ever seen?

Toshi Reagon.

She performs every year on her birthday at Joe's Pub here in New York City.

Great.

And it's the best concert ever.

Last book that blew you away.

"Hijab Butch Blues" by Lamya H. Lamya was my writing student, so I'm really proud of her.

It's about being queer and Muslim, a memoir.

If your high school did superlatives, what would you have been most likely to become?

My superlative in high school was that I would be the first Black woman president.

Who is your favorite celebrity crush?

Jill Biden.

I'm just really impressed with her that she's made the intentional choice to teach community college.

What's something big you've been wrong about?

When I was at "Essence" magazine, my assistant was friends with this woman named Michelle, so I was talking to Michelle, and I said, "What do you want to do with yourself?"

And she said, "I want to be a rapper."

I was like, "OK. What's your plan B?"

And she said, "Oh, I want to go to barber school."

So I said, "You know, I think you should go to barber school."

Michelle became Meshell Ndegeocello.

I was wrong, and I also apologized to her, though she doesn't need it because she's a wonderful singer.

That's great.

Is there anyone you would like to apologize to?

I'd like to apologize to my high school class because I did not become and will not be the first Black woman president.

What's your go-to mantra for hard times?

In the words of the late, great Aaliyah, "Dust yourself off and try again."

Thanks a lot for your time and your work.

It's so wonderful to be with you.

Thank you.

Here are my takeaways from my conversation with Linda Villarosa.

Number one, it's easy to blame the victims.

Smart, well-meaning people do it all the time by accident.

Number two, step one in getting things right-- confront your bias.

Number 3, race is not a proxy for poverty, and poverty is not a proxy for race.

And number 4, until we fix the system, which we must, the limp along plan will have to be love.

♪ ♪ ♪